The Medi-Cal Program: An Overview

Margaret Tatar, Health Management Associates
Health Management Associates
Athena Chapman
Chapman Consulting


Medi-Cal is the primary source of health insurance for more than 13 million people in California — a third of the state’s population. The program provides health coverage for low-income children and their parents, pregnant women, seniors, and nonelderly adults, including people with disabilities. For low-income seniors, Medi-Cal also covers services not paid for by Medicare, including nursing home care.

This publication is geared toward those who need a high-level understanding of the program, or those who are looking for a refresher. Topics include:

  • Who is served by the program?
  • What is the application process?
  • How are enrollees covered?
  • What benefits and services are covered?
  • What is Medi-Cal managed care? What services are carved out? How is payment structured?
  • Which agencies provide oversight for the program?
  • How is the program’s performance measured?
  • How is the program financed?
  • What role do waivers serve in the program?
  • What pilot programs exist under Medi-Cal?
  • What issues will face the program in the future?

This publication is part of the Medi-Cal Explained series.